Rescuers struggle to find earthquake survivors in Turkey and Syria, as more than 20,000 confirmed dead

Rescue workers made a final push Thursday to find survivors of the earthquake in Turkey and Syria that rendered many communities unrecognizable to their inhabitants and killed more than 20,000.

It was not clear how many people were still unaccounted for in both countries.

Monday'searthquake affected an area that is home to 13.5 million people in Turkey and an unknown number in Syria. Even with an army of people taking part in the rescue effort, crews had to pick and choose where to help.

The scene from the air showed the scope of devastation, with entire neighbourhoods of high-rises reduced to twisted metal, pulverized concrete and exposed wires.

Even though experts say people could survive for a week or more, the chances of finding survivors in the freezing temperatures were dimming.

As emergency crews and panicked relatives dug through the rubble and occasionally found people alive the focus began to shift to demolishing dangerously unstable structures.

The DHA news agency broadcast the rescue of a 10-year-old in Antakya. The agency said medics had to amputate an arm to free her.

A 17-year-old girl emerged alive in Adiyaman, and a 20-year-old was found in Kahramanmaras by rescuers who shouted "God is great."

In Nurdagi, a city of around 40,000 nestled between snowy mountains some 56 kilometresfrom the quake's epicentre, vast swaths of the city were levelled, with scarcely a building unaffected. Even those that did not collapse were heavily damaged, making them unsafe.

Throngs of onlookers, mostly family members of people trapped inside, watched as heavy machines ripped at one building that had collapsed, its floors pancaked together with little more than a few inches in between.

Hope dwindling

Mehmet Yilmaz, 67, watched from a distance as bulldozers and other demolition equipment began to bring down what remained of the building where six of his family members had been trapped, including four children.

He estimated that about 80 people were still beneath the rubble and doubted that anyone would be found alive.

"There's no hope. We can't give up our hope in God, but they entered the building with listening devices and dogs, and there was nothing," Yilmaz said.

Mehmet Nasir Dusan, 67, sat watching as the remnants of the nine-storey building were brought down in billowing clouds of dust. He said he held no hope of reuniting with his five family members trapped under the debris.

Still, he said, recovering their bodies would bring some small comfort.

"We're not leaving this site until we can recover their bodies, even if it takes 10 days," Dusan said. "My family is destroyed now."

In Kahramanmaras, the city closest to the epicentre, a sports hall the size of a basketball court served as a makeshift morgue to accommodate and identify bodies.

On the floor lay dozens of bodies wrapped in blankets or black shrouds. At least one appeared to be that of a 5- or 6-year-old.

Workers continued to conduct rescue operations in Kahramanmaras, but it was clear that many who were trapped in collapsed buildings had already died. One rescue worker was heard saying that his psychological state was declining and that the smell of death was becoming too much to bear.

Challenges for survivors

While stories of miraculous rescues briefly buoyed spirits, the grim reality of the hardship facing survivors cast a pall over devastated communities.

Hundreds of thousands of people have been left homeless in the middle of winter. Many have camped out in makeshift shelters in supermarket parking lots, mosques, roadsides or amid the ruins since Monday's 7.8-magnitude quake, often desperate for food, water and heat.

WATCH |Homeless survivors face hopelessness:

The enormous scale of earthquakes destruction in Turkey

2 years ago

Duration 2:41

CBCs Briar Stewart shows the full scale of the devastation in the Turkish cities of Pazarck and Gaziantep, located at the epicentre of the second deadly earthquake that struck Turkey.

In the Turkish city of Antakya, dozens scrambled for aid in front of a truck distributing children's coats and other supplies.

One survivor, Ahmet Tokgoz, called for the government to evacuate people from the region. Many of those who have lost their homes found shelter in tents, stadiums and other temporary accommodation, but others have slept outdoors.

"Especially in this cold, it is not possible to live here," he said. "If people haven't died from being stuck under the rubble, they'll die from the cold."

The winter weather and damage to roads and airports have hampered the response. Some in Turkey have complained that the government was slow to respond a perception that could hurt Turkish President Recep Tayyip Erdogan at a time when he faces a tough battle for reelection in May.

UN aid reaches Syria

In northwest Syria, the first UNaid trucks to enter the rebel-controlled area from Turkey since the quake arrived, underscoring the difficulty of getting help to people in the country riven by civil war.

UN officials said more trucks were set to follow with assistance specifically for the current crisis.

Aid efforts in Syria have been hampered by the ongoing war and the isolation of the rebel-held region along the border, which is surrounded by Russia-backed government forces. Meanwhile, Syria itself is an international pariah under Western sanctions linked to the war.

The UN is authorized to deliver aid through only one border crossing, and road damage has prevented that thus far. UN officials pleaded for humanitarian concerns to take precedence over wartime politics.

In the Syrian government-held city of Aleppo, rescue workers pulled seven people out alive and 44 bodies from a collapsed building in the city centre on Thursday, state TV reported.

"We are racing against time. Time is running out," said the Syrian paramedic group in the rebel-held northwest known as the White Helmets. "Every second could mean saving a life."

UN special Syria envoy Geir Pedersen earlier said people impacted by the earthquake needed "more of absolutely everything" in terms of aid.

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Front Burner21:23Brother in Syria, sister in Canada, helpless after devastating earthquake

Prior to the earthquake, the UN had estimated that more than fourmillion people in northwest Syria, many displaced by the 12-year conflict there, depended on cross-border aid.

The earthquake's toll is the highest worldwide since a 2011 earthquake off Japan triggered a tsunami, killing nearly 20,000 people.